Abstract:

This paper will focus on trauma-related dissociation of the personality.  It is essential for mental health professionals to have a basic accurate understanding of what dissociation is (and is not), to recognize it, and to promote management of it during and between psychotherapeutic interventions.  Differentiating alterations in consciousness from structural dissociation of the personality is crucial in formulating conceptualizations of clients’ problems, a treatment plan, and assessing risk.  The wide range of experiences and phenomena involving alterations in consciousness that have been labeled (or mislabeled) as dissociation will be discussed.  A conceptualization recently formulated and widely lauded because of its clarity and capacity to unify symptoms, psychobiological mechanisms, and treatment is presented.  This is elaborated to describe and explain the causes and developmental pathways of trauma-related dissociation.  A phased-treatment approach is presented that is consistent with this conceptualization with an emphasis on preparation and stabilization for trauma processing work.  This paper concludes with a brief reflection on how the ideas and knowledge about trauma processing and dissociation might apply to the experiences and psychological treatments of people with severe and chronic breathing disorders.

Key words :  Dissociation, Trauma, Psychotherapy, Conceptualization